ORIGINAL_ARTICLE
A Prospective Randomized Study of Prophylactic Irradiation of Tracts in Patients with Malignant Pleural Mesothelioma
Background: Procedure tract metastasis (PTM) may complicate pleural procedures in malignant pleural mesothelioma (MPM) patients and cause significant morbidity.Aim: To evaluate the effectiveness of prophylactic radiotherapy (RTH) in preventing PTM and reducing pain.Methods: Forty patients with MPM, who had a pleural invasive procedure within the preceding 15 days, were randomized in a 1:1 ratio to receive prophylactic RTH to the procedure site (21 Gy in three consecutive daily fractions using 9MeV) vs. no RTH. During a 12-month follow up period, patients were examined monthly for PTM, toxicities and pain at the procedure site.Results: Patients receiving RTH had lower incidence of PTM than the control group (2/20, 10% vs. 5/20, 25%); however, this difference was not statistically significant. The proportion of patients who experienced pain at the pleural procedure site was significantly less in the RTH group compared with the control group (2/20, 10% vs. 12/20, 60%; p=0.001). Pain scores were significantly less in the RTH group compared with the control group (mean pain score 1.6 vs. 2.8, respectively; p=0.014).Conclusion: Prophylactic RTH to the pleural procedure site in MPM was not significantly effective in preventing or delaying PTM. However, prophylactic RTH reduced significantly the rate and severity of pain at the procedure site. Future studies may be needed to assess the effect of prophylactic RTH timing and its technique on preventing PTM.
https://resoncol.journals.ekb.eg/article_4200_dcbfe197b07476aa8d81885d3f9502e8.pdf
2017-12-01
28
32
10.21608/resoncol.2017.1229.1028
mesothelioma
Radiotherapy
Procedure tract metastasis
Pain
Nesreen
Mosalam
dr.nesreen2000@gmail.com
1
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
LEAD_AUTHOR
Ahmed
Nagy
2
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience
Background: Pancreatic carcinoma is an uncommon tumor with a high mortality rate. Because of the late presentation ofthe disease, only a small percent of patients are candidate for surgery. Aim: To assess the epidemiology and the clinical outcome of patients diagnosed with pancreatic adenocarcinoma presented to the Clinical Oncology Department at Menoufia University. Methods: All patients presenting with exocrine pancreatic carcinoma from January 2007 to December 2011 were included. Epidemiological features of patients and their treatment details and outcome were collected retrospectively from the medical records. An equal number of matched controls were interviewed and filled a uestionnaire to identify possible risk factors. Results: Exocrine pancreatic adenocarcinoma represented 1.4 % of all cancer patients treated at our institution. The study included 76 patients and 76 controls. Pancreatic cancer patients were significantly more likely to be overweight when compared to controls (OR= 2.51, 95%CI: 1.04-6.06). Diabetes mellitus and smoking were significantly more prevalent among patients (OR= 2.36, 95%CI: 1.23-4.54; OR= 2, 95%CI: 1.05-3.81; respectively). The median time to progression was 12 weeks (95%CI: 9.46-14.53) and the median overall survival was 16 weeks (95%CI: 12.22-19.78). Patients with earlier tumor stage and those who underwent surgery followed by adjuvant chemotherapy had significantly better overall survival (p=0.02 and <0.001, respectively).Conclusion: Exocrine pancreatic adenocarcinoma is an uncommon tumor among cancer patients treated at the ClinicalOncology Department of Menoufia University. Diabetes mellitus, higher body mass index and smoking are significantlymore prevalent in pancreatic carcinoma patients. Earlier tumor stage and undergoing surgery followed by chemotherapy are associated with statistically significant better overall survival.
https://resoncol.journals.ekb.eg/article_4201_2583936c416a6ec1aebae3f0da84818d.pdf
2017-12-01
33
39
10.21608/resoncol.2017.1026.1026
Pancreatic adenocarcinoma
Epidemiology
Survival
Suzy
Gohar
suzygohar@ymail.com
1
Clinical Oncology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
LEAD_AUTHOR
Fawzy
Megahid
2
Internal Medicine Department, Faculty of Medicine, Benha University, Benha, Egypt
AUTHOR
Mahmoud
Rizk
3
Internal Medicine Department, Faculty of Medicine, Benha University, Benha, Egypt
AUTHOR
Zeinab
Kasemy
4
Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
AUTHOR
Tamer
Barsoom
5
Internal Medicine Department ,Benha Teaching Hospital, Benha, Egypt
AUTHOR
ORIGINAL_ARTICLE
Dosimetric Evaluation of Advanced Radiotherapy Techniques in Treating Patients with Prostatic Cancer
Background: Different radiotherapy techniques were developed to deliver optimal dose to prostate cancer while sparing nearby organs at risk (OARs).Aim: To compare different dosimetric methods used to evaluate sparing of OARs and to select radiotherapy plan which provides the most OARs sparing during prostate cancer treatment.Methods: We used computed tomography data sets of 10 patients. For each data set, six plans were calculated; two RapidArc, two intensity-modulated radiation therapy (IMRT), and two 3-dimensional conformal radiotherapy (3DCRT) plans. Isodose distribution and dose volume histograms (DVHs) were used for plan analysis and evaluation. The dose to OAR was compared by calculating the DVH for each OAR in different plans. The dose (D) delivered to certain percentage (n) of an organ (Dn) was then determined. In addition, the Critical Organ Scoring Index (COSI) and the modified COSI (mCOSI) were calculated.Results: 3DCRT with 5 fields produced the lowest rectal dose, RapidArc with bladder avoidance sector (RapidArc-Bladder) produced the lowest bladder dose and IMRT with 9 beams produced the lowest dose to the femoral heads. The COSI and MCOSI values of the two IMRT plans were significantly lower than those of 3DCRT and RapidArc (<0.0001). The calculation of mCOSI produced similar results to that obtained with COSI (<0.0001).Conclusion: The results of this study showed that COSI and MCOSI are better dosimetric methods in selecting the plan with more sparing of OARs than Dn. Meanwhile among advanced radiotherapy techniques, RapidArc and 3DCRT are more sparing of OARs than IMRT.
https://resoncol.journals.ekb.eg/article_4203_7d1f112b890c949ca3a20b8e21b8e2d4.pdf
2017-12-01
40
45
10.21608/resoncol.2017.1654.1036
Radiotherapy planning
Organ at risk
Dosimetric evaluation
Critical Organ Scoring Index (COSI)
Amin
Amin
aminelsayed@yahoo.com
1
Medical Physics, Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Somaia
El Sayed
2
Medical Physics, Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Ahmed
Ezzat
ahmedezzat200011@gmail.com
3
Clinical Oncology, Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of Neoadjuvant Chemotherapy in Treatment of Muscle Invasive Urothelial Bladder Tumors in Upper Egypt
Background: Bladder cancer is a common health problem is Egypt where it is the 3rd common cancer (6.9%) in both sexes and the 2nd common (10.7%) among males. Neoadjuvant chemotherapy has proven benefits in treatment of muscle invasive bladder cancer (MIBC), yet it is still underutilized. Aim: To study the response to neoadjuvant chemotherapy in patients with MIBC and their attitude towards definitive treatment after completion of neoadjuvant therapy. Methods: In this prospective study, 85 patients with MIBC were recruited between September 2013 and September 2014. They were scheduled to receive three cycles of gemcitabine (1000 mg/m2, on days 1 and 8) plus cisplatin (75 mg/m2 on day 1) or carboplatin (AUC=5 on day 1) in patients with impaired renal function prior to definitive treatment. Results: Sixty-seven patients were evaluable for response and toxicity. The majority (79%) were males and their median age was 61 years (range: 38-84). The initial T stage was T3 or T4 in 72% of patients. Complete response was documented in 6 (9%) patients, partial response in 41 (61.2%), stationary disease in 5 (7.5%) and progressive disease in 15 (22.4%). Grade III and IV toxicities were infrequent (5%) with no chemotherapy-related mortality. After completion of the treatment, 9 (13.4%) patients were shifted to bladder preservation treatment due to complete radiological response and refusal of surgery. Conclusion: Neoadjuvant chemotherapy is feasible in MIBC patients in our setting as it gives good clinical response. If offered in a proper way, it doesn’t preclude the patients’ chances for definitive treatment.
https://resoncol.journals.ekb.eg/article_4204_b1a010c9ed3c0f2d594d22898fe668f7.pdf
2017-12-01
46
50
10.21608/resoncol.2017.1246.1029
Bladder cancer
Neoadjuvant chemotherapy
Bladder preservation
Uro-oncology
Upper Egypt
Mohamed
Khateeb
1
Urology University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Diaa
Hameed
diaa_hameed@hotmail.com
2
Urology University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Ahmed
Moeen
3
Urology University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Tareq
Salah
tareqsalah41@yahoo.com
4
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt
LEAD_AUTHOR
Hosney
Behnsawy
h111behnsawy@gmail.com
5
Urology University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Yasser
Abdelsalam
6
Urology University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Samir
Shehata
7
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Magdi
El-Akkad
8
Urology University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Relationship between Distressing Symptoms and Performance Status among Cancer Patients Receiving Palliative Care
Background: Patients with advanced cancer experience distressing symptoms and progressive decline in theirperformance status (PS) as death approaches.Aim: To identify the relationship between symptom burden and PS of Egyptian cancer patients receiving palliative care.Methods: This was a prospective observational study that included 100 patients with advanced cancer. Symptom burdenwas assessed using the Arabic version of the revised Edmonton Symptom Assessment System (ESAS-r). Performancestatus was assessed using the Palliative Performance Scale (PPS).Results: The mean total ESAS-r score was 60.1 (±10.7). The most common symptom to be reported as severe was pain(93%) followed by tiredness (74%), poor wellbeing (67%), lack of appetite (62%), anxiety (60%) and drowsiness (56%).The majority of patients (76%) had a PPS score ≤30 with an overall mean PPS score of 36.2 (±13.3). There was astatistically significant negative correlation between the total ESAS score and the PPS score (r = - 0.687, p = < 0.001).Conclusion: The results suggest that Egyptian patients with advanced cancer experience high symptom burden andsignificant decline in PS. The higher the symptom burden, the poorer the PS of patients with advanced cancer.
https://resoncol.journals.ekb.eg/article_4205_e4a072733bbca65afbfc476508964d24.pdf
2017-12-01
51
55
10.21608/resoncol.2017.1331.1032
Advanced cancer
Symptom burden
Performance status
Palliative Care
Egypt
Fatma
Hussenein
boody662010@yahoo.com
1
Medical Surgical Department, Faculty of Nursing, Cairo University, Egypt
LEAD_AUTHOR
Hanaa
Hashem
hanaayoussry@yahoo.com
2
Medical Surgical Department, Faculty of Nursing, Cairo University, Egypt
AUTHOR
Shaimaa
El Hadary
3
Medical Surgical Department, Faculty of Nursing, Cairo University, Egypt
AUTHOR
Samy
Alsirafy
alsirafy@kasralainy.edu.eg
4
Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy,School of Medicine, Cairo University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Bilateral Phyllodes Tumor of the Breast; a Case Report of Benign Tumor on One Side and Malignant Tumor on the Contralateral Side
Introduction: Phyllodes tumors (PTs) of the breast are rare fibroepithelial neoplasms which may be benign, borderline or malignant. Malignant PTs tends to recur more frequently and has the potential to metastasize. Bilateral PT is a rare presentation of the disease.Case presentation: We report a case of 34 years old female patient with bilateral breast PT, malignant on one side and benign on the contralateral one. First, she underwent lumpectomy for right breast benign PT which recurred six month later and underwent right mastectomy. One year later, she underwent excision of left breast borderline PT which recurred six months later. The recurrence was in the form of malignant PT for which she underwent mastectomy. Almost one year later, she developed right chest wall recurrence and was found to have bone, brain and lung metastases. She received one cycle of ifosfamide plus doxorubicin with no noticeable response after which she deteriorated rapidly and died few weeks later.Discussion: Bilateral breast PT is very rare and its management represents a challenge in view of limited evidence.
https://resoncol.journals.ekb.eg/article_4206_078a65b108340acae23a70f907af6911.pdf
2017-12-01
56
58
10.21608/resoncol.2017.356.1012
Phyllodes tumor
Breast
Bilateral
Metastases
Hamdy
Abdel Azim
1
Clinical Oncology department, Kasr Al-Ainy School of medicine, Cairo University, Cairo, Egypt
AUTHOR
Omar
Abdel-Rahman
omar.abdelrhman@med.asu.edu.eg
2
Clinical Oncology department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
AUTHOR
Raafat
Abdel-Malek
raafat.malek@kasralainy.edu.eg
3
Clinical Oncology department, Kasr Al-Ainy School of medicine, Cairo University, Cairo, Egypt
LEAD_AUTHOR